When the doctor prescribes BPC-157 to an athlete: anti-doping lessons

What is prohibited

The World Anti-Doping Agency's 2026 Prohibited List bans at all times: BPC-157 under S0 (non-approved substances); "Thymosin-β4 and its derivatives e.g. TB-500" under S2.3; and GHRP-2, GHRP-6, CJC-1295, ipamorelin and ibutamoren (MK-677) under S2.2.4¹. Anti-doping laboratories have validated methods to detect these compounds in urine: BPC-157¹⁰, the GHRPs, including ipamorelin¹¹, and a thymosin β4 fragment identified in products sold as TB-500¹².

"A doctor gave it to me" does not protect the athlete

In 2023 UFC fighter Cortney Casey accepted a four-month sanction; according to USADA, Casey "was prescribed and provided BPC-157 by a doctor to help treat a medical condition". USADA explained that "A Therapeutic Use Exemption (TUE) was not applicable to this Non-Approved Substance"². In 2024, in another case (a speed skater), an independent arbitrator imposed a one-year suspension over a BPC-157 supplement "recommended by a medical provider"³. The underlying rule is strict liability: according to USADA, an athlete "is responsible for any prohibited substance found in their body, regardless of intent"⁸. And even when a treatment is prescribed, USADA tells athletes to check its anti-doping status, a warning it aims in particular at athletes who visit wellness and anti-aging clinics⁹.

The key point for physicians: for BPC-157, a prescription is not enough. In the 2023 case, USADA said a therapeutic use exemption was not applicable to this non-approved substance²; today it explains that a TUE for BPC-157 is "unlikely" to be approved because permitted alternatives exist, although it considers each application case by case⁷. S0 substances are, by definition, those with no approval from any health authority for human therapeutic use¹. USADA adds that there is currently "no legal basis to include BPC-157 in any compounded medication" in the United States⁷.

Peptides hidden in "treatments"

In 2019 fighter C.B. Dollaway was banned for two years after testing positive for GHRP-2 and GHRP-6, plus anastrozole (and, in another sample, clomiphene); he attributed it to a stem cell procedure received in Mexico⁴. The case illustrates a risk for athlete patients: they do not always know what is in what they are injected with. Analyses of black-market products confirm that risk: in Norway, 28% of products confiscated between 2011 and 2014 contained peptide- or protein-based doping agents¹⁴, and an international study found anabolic steroids not declared on the label in 14.8% of 634 "non-hormonal" supplements¹³. The BPC-157 that a US anti-doping laboratory characterized in 2017 itself came from confiscated vials¹⁰.

Panama

We found no Panamanian sanctions for peptides, but there are cases that show the pattern. A triathlete competing for Panama received a 2-year ban for clostebol from a healing spray that, according to La Estrella, "is available in Panama without a prescription", used on medical advice⁵. Baseball player Anthony Amaya was banned for 3 years and 9 months for stanozolol⁶. Clostebol is sold over the counter as creams and sprays in several countries; applied to the skin, it can leave detectable metabolites in urine even after a single exposure, and experts have called for athletes to be warned about these preparations¹⁵.